Healthcare Provider Details

I. General information

NPI: 1790557403
Provider Name (Legal Business Name): ZACKARY STRUNIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2023
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2631 MERRICK RD STE 302
BELLMORE NY
11710-5784
US

IV. Provider business mailing address

5920 WILLOWCREST AVE APT #4
NORTH HOLLYWOOD CA
91601
US

V. Phone/Fax

Practice location:
  • Phone: 516-308-4966
  • Fax:
Mailing address:
  • Phone: 781-733-2253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: